Village of Beloit

Primary specialty

AmbulanceTaxonomy code 341600000X

License

020320250 Issued in OH

Legal business name

VILLAGE OF BELOIT

Doing business as

Beloit Vol F.D. Rescue Squad

Practice address

17893 East Fifth St
Beloit, OH 44609

Phone

(330) 938-9305

Fax

(330) 938-9305

NPI assigned

Jul 1, 2006

Last updated

Feb 13, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

VILLAGE OF BELOITAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Debra S Hartzell

Title

Fiscal Officer

Phone

(330) 525-7278

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• BELOIT VOL F.D. RESCUE SQUAD Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Part of

Village of Beloit

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1013946284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276",
            "city": "BELOIT",
            "state": "OH",
            "postal_code": "446090276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17893 EAST FIFTH ST",
            "city": "BELOIT",
            "state": "OH",
            "postal_code": "44609",
            "telephone_number": "330-938-9305",
            "fax_number": "330-938-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF BELOIT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VILLAGE OF BELOIT",
        "enumeration_date": "2006-07-01",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "HARTZELL",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "FISCAL OFFICER",
        "authorized_official_telephone_number": "330-525-7278",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "OH",
            "license": "020320250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000252909",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0475632",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590013819",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BELOIT VOL F.D. RESCUE SQUAD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• April Waidman
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• Crystal L Woods
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• Ambulance in Beloit, OH
• Providers in Beloit, OH by specialty
• Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.